Your full name: :
Your email address: (e.g.: you@yourhostname.com) :
Your complete address: :
Your phone number (with country, city, area codes): :
Litter of interest: :
Occupation: :
Average hours worked weekly: :
Number of adults in your household? :
Age? :
18-25
26-35
36-45
46-55
56-65+
Number of hours that someone is home during each day (include yourself)? :
The number of children and their ages in your household? :
What member of the family will be taking the MAJOR responsibility for raising a new puppy? :
Does anyone in the household have any pet related allergies? :
yes no
What type of area do you live in? :
City
Country
Suburban
Are you familiar with any of the Breed Specific Legislation? :
yes no
What type of housing do you live in? :
Apartment
Condo
Farm
House
Townhouse
Do you own or rent your home/apartment/townhouse/condo/farm? :
Own
Rent
If you live in a condo or townhouse, have you verified with the commitee if they allow your new pup? :
yes no
If you rent, do you have permission from your landlord to own a Rottweiler? :
yes no
If yes, Can you provide a name and phone number for verification? :
Where will your Rottweiler live? :
Inside
Outside
How much time will your dog spend alone in one day? :
Do you have enough time in your day to devote to a puppy? :
yes no
How much time in one day are you willing to devote to a dog? :
0-2 hours
2-4 hours
4-6 hours
6-8 hours
All Day
Do you have enough time in your day to excersise a puppy? :
yes no
Do you have a fenced yard? :
yes no
If yes, what is the aproximate size of the fenced area? :
If no, where will the puppy be exercised and be allowed to eliminate? (Explain) :
What are the major activites , hobbies, or exercises you and your family most participate in? :
Is this your first dog? :
yes no
Is this your first Rottweiler? :
yes no
How much do you expect your puppy will cost you per month? per year? (explain) :
Are you aware of any breed bans in your area? :
yes no
What kinds of previous experiences have you and/or the members of your household had with dogs? of w :
What breeds of dogs have you previously owned, and what happened to them? :
Have you or any other member of your family ever had any negative expirences with dogs? :
yes no
If yes, please explain... :
Do you have anyother animals living in your house? If yes, what breed/types and how many? :
What do you know about Rottweilers as a breed? What do you find attractive about them? :
Have you ever considered adopting from a breed shelter? :
yes no
How did you hear about Riverdale Rottweilers, and whom referred you to us? :
Have you considered any other litters? :
Do you have a preference of what sex of puppy you get? :
yes no
If yes, what is your preference and why? :
Are you willing to sign and abide by a contract that includes things such as expectations, registrat :
yes no
Would you take this puppy to obedience classes? :
yes no
If so, have you considered where you would take them? :
Would your Rottweiler have clear rules to follow in the household? :
yes no
Would your Rottweiler sleep on the bed with you? :
yes no
Would your Rottweiler be allowed on the furniture? :
yes no
What are your plans and goals for this puppy?...show? working? companion? :
Have you ever taken a dog to training classes before? :
yes no
Do you believe in dog crates? :
yes no
What veterinarian do you currently use, or would you use? :
Would you mind if I gave them a call as a reference? :
yes no
If no, can you please include the phone number to the clinic? :
Would you ever conside getting you pet health insurance? :
yes no
What would you do if you puppy needed emergency surgery, in the case of an accident? :
Anything else you would like to include? :
I certify that the above information is correct and true. E-Signature: :
Please type the text below :
